scholarly journals CT-guided Chemical Lumbar Sympathectomy in the Treatment of Cold Hypersensitivity in the Hands and Feet

2021 ◽  
pp. E459-E466
Keyword(s):  
Therapeutic Effect ◽  
Visual Analog Scale ◽  
Statistical Significance ◽  
Perfusion Index ◽  
Analog Scale ◽  
Invasive Blood Pressure ◽  
Lumbar Sympathectomy ◽  
Non Invasive ◽  
Hands And Feet ◽  
Cold Hypersensitivity

BACKGROUND: Cold hypersensitivity in the hands and feet is a common clinical symptom in Asian women. Currently, treatment of cold hypersensitivity in the hands and feet is still limited to traditional Chinese medicine, mainly herbal medicine. However, many patients with cold hypersensitivity in the hands and feet in China are not satisfied with the therapeutic effect of herbal medicine, and took medication for a longer time. Chemical lumbar sympathectomy is widely used in the treatment of plantar hyperhidrosis, diabetic foot, recalcitrant erythromelalgia, and other diseases. OBJECTIVES: This study was conducted to evaluate the short-term as well as long-term efficacy, complications, and patient satisfaction of chemical lumbar sympathectomy during treatment cold hypersensitivity in the hands and feet. STUDY DESIGN: A retrospective, observational study. SETTING: Department of Anesthesiology and Pain Medicine, Jiaxing, China. METHODS: A retrospective study of 72 patients with cold hypersensitivity in the hands and feet who received chemical lumbar sympathectomy treatment in our hospital from January 2015 to October 2018 was conducted. The heart rate, non-invasive blood pressure, oxygen saturation, visual analog scale, perfusion index, and plantar temperature were monitored and recorded in before treatment (T1) and after treatment (T2) groups. The patients were followed up on day 1, at week 1, 1 month, 3 months, 6 months, one year, and 2 years after operation for satisfaction, complications, and recurrence. RESULTS: There were no significant differences in heart rate, non-invasive blood pressure, and oxygen saturation between T1 and T2 groups (P > 0.05). Perfusion index and plantar temperature in T2 group were remarkably higher than T1 group, and the difference was statistically significant (P < 0.01). The visual analog scale score of the T2 group was significantly reduced (P < 0.01). Of all the patients who underwent chemical lumbar sympathectomy, the postoperative therapeutic effect was effective in 63 cases (87.5%) and ineffective in 9 cases (12.5%). Among the effective patients, the postoperative curative effect was shown to be excellent in 47 cases and improved in 16 cases. According to the follow-up results at day 1, 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years after operation, the satisfaction rate was 87.5%, 87.5%, 81.9%, 61.1%, 52.7%, 41.6%, and 34.7%, respectively. There were no serious complications observed and 23 patients relapsed after two years. Multivariate logistic regression analysis results showed that the effect of visual analog scale (OR = 7.312, 95% CI: 1.598 – 33.646, P = 0.011) and plantar temperature (OR = 0.470, 95% CI: 0.288 – 0.766, P = 0.002) on therapeutic effect showed has statistical significance; the effect of gender (OR = 0.654, 95% CI: 0.134 – 3.181, P = 0.599), age (OR = 0.975, 95% CI: 0.916 – 1.039, P = 0.441), perfusion index (OR = 0.710, 95% CI: 0.367 – 1.375, P = 0.310), and disease course (OR = 1.019, 95% CI: 0.997 – 1.042, P = 0.088) on therapeutic effect showed no statistical significance. The effect of gender (OR = 0.451, 95% CI 0.131 – 1.554, P = 0.207), age (OR = 0.961, 95% CI 0.912 – 1.013, P = 0.141), and course of disease (OR = 1.006, 95% CI 0.997 – 1.015, P = 0.203) on postoperative recurrence showed no statistical significance. LIMITATIONS: The nonrandomized, single-center, small sample size, retrospective design is a major limitation of this study. CONCLUSIONS: Chemical lumbar sympathectomy is a valid treatment option for cold hypersensitivity in hands and feet, and computed tomography-guided percutaneous puncture chemical lumbar sympathectomy has the advantages of high success rate, less invasion, less complications, and repeatablity. KEY WORDS: Cold hypersensitivity in hands and feet, chemical lumbar sympathectomy, computed tomography-guided

Correlation between three assessment pain tools in subacromial pain syndrome

2020 ◽  
pp. 026921552094759
Author(s):  
Javier Aceituno-Gómez ◽  
Juan Avendaño-Coy ◽  
Juan José Criado-Álvarez ◽  
Gerardo Ávila-Martín ◽  
Ana Cecilia Marín-Guerrero ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Visual Analog Scale ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Pain Syndrome ◽  
Assessment Tools ◽  
Linear Regression Models ◽  
Analog Scale ◽  
Subacromial Pain Syndrome ◽  
Constant Murley Score

Objective: To compare the correlation of Visual Analog Scale with pain subsections of Shoulder Pain and Disability Index and Constant-Murley Score in subacromial pain syndrome patients. Design: Single cross-sectional analysis. Setting: Hospital Rehabilitation Department. Methods: The assessment tools were applied at baseline. Correlations between Visual Analog Scale, Shoulder Pain and Disability Index and Constant-Murley Score pain subsections were assessed by Pearson correlation coefficient. Linear regression models were calculated between scales. Statistical significance was set at two-sided p < 0.05. Results: Forty-three patients were included. Pearson’s correlation between assessments was for Visual Analog Scale-Shoulder Pain Disability Index-pain ( r = 0.61, p < 0.001) and for Visual Analog Scale-Constant Murley Score-pain were ( r = −0.74, p < 0.001). Visual Analog Scale-Shoulder Pain and Disability Index-pain determination coefficient was r2 = 0.37 and r2 = 0.54 for Visual Analog Scale-Constant-Murley Score-pain. Conclusions: Visual Analog Scale showed better correlation with Constant Murley Score-pain than with Shoulder Pain and Disability Index-pain in subacromial pain syndrome patients.

scholarly journals Randomized Clinical Trial Evaluating Transdermal Ibuprofen for Moderate to Severe Knee Osteoarthritis

2013 ◽  
Vol 6;16 (6;11) ◽  
pp. E749-E762
Author(s):  
Dr. Gyula Varadi
Keyword(s):  
Clinical Trial ◽  
Knee Osteoarthritis ◽  
Visual Analog Scale ◽  
Statistical Significance ◽  
Academic Medical Center ◽  
Osteoarthritis Of The Knee ◽  
Clinical Effects ◽  
Phase 2 ◽  
Analog Scale ◽  
Clinical Endpoints

Background: Osteoarthritis is a common condition, typically treated with orally administered analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Chronic administration of NSAIDs, serotoninnorepinephrine reuptake inhibitors (SNRIs, i.e., duloxetine), and opioid medications (i.e., tramadole) is regularly associated with multiple, serious side effects, in part due to the route of administration. Transdermal delivery of NSAIDs, such as ibuprofen, represents a potentially alternative treatment for this inflammatory pain condition with a better therapeutic profile. Objective: Investigate the safety and efficacy of a novel transdermal ibuprofen formulation (VALE®- ibuprofen) containing 10% ibuprofen, compared to a placebo in a randomized, double-blinded clinical trial, for clinical improvement in patients with moderate to severe painful osteoarthritis of the knee. Study Design: A randomized, placebo-controlled, double blind, multi-center Phase 2 clinical trial. Setting: An academic medical center, and private rheumatology and interventional pain management practices in Massachusetts and in Switzerland. Methods: The Phase 2 clinical study included patients with primary osteoarthritis in a single knee joint with a progression level of moderate to severe based in part on a grade II or III designation according to the Kellgren and Lawrence classification system. Patients received the corresponding, randomly assigned study formulation (VALE-ibuprofen or placebo) for application to the target knee at a dose of 2.0 grams of drug product (200 mg ibuprofen) twice daily for 14 days. The evaluation of the efficacy of the treatments utilized the widely accepted methods of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Visual Analog Scale (VAS) scores for the patients. Results: The results indicate that the transdermal VALE-ibuprofen formulation was very well tolerated from a safety perspective during the 2-week trial and also produced significant, positive clinical improvements superior to the placebo in all clinical endpoints tested. In particular, the WOMACTotal and WOMACPhysical Functioning, for the VALE-ibuprofen, were superior compared to the placebo (P = 0.0283 and P = 0.0201, respectively). Other clinical endpoints including the WOMACPain, WOMACStiffness, and VASResting scores were superior to those obtained from the placebo group, trending towards statistical significance compared to placebo (P = 0.0811, 0.1103, and 0.0785, respectively). Based on the Patient and Physician Global Impression of Change survey, patient satisfaction slightly improved across both groups; however, no statistical significance was detectable as compared to the baseline. Limitations: The sample size of 64 subjects in the final data analysis and the lack of including an orally administered drug group are limitations of this study. Conclusions: The use of transdermal VALE-ibuprofen has beneficial clinical effects on the pain levels experienced in some patients with moderate to severe osteoarthritis of the knee as measured by the WOMAC Osteoarthritis Indices for stiffness, pain, physical function, and total. Visual Analog Scales (VAS) tests, VASMotion and VASWeight-bearing, again while appeared superior to placebo, were not statistically different from placebo. Clinical Trial Registration: NCT01496326 Key words: Ibuprofen, transdermal treatment, VALE-ibuprofen, knee osteoarthritis, Visual Analog Scale, WOMAC score

Therapeutic Effect of a Traditional Chinese Medicine on the Treatment of Painful Leg Ulcer

2019 ◽  
Vol 19 (1) ◽  
pp. 89-98
Author(s):  
Xuya Lu ◽  
Qiang Xu ◽  
Pinchuan Li ◽  
Zhaohui Zhang
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Therapeutic Effect ◽  
Visual Analog Scale ◽  
Treatment Protocol ◽  
Visual Analog Scale Score ◽  
Leg Ulcer ◽  
Epithelial Tissue ◽  
Analog Scale ◽  
Wound Pain

This study aimed to investigate the therapeutic effect of a traditional Chinese medicine on the treatment of painful leg ulcer. Twelve cases of painful leg ulcer were recruited and their characteristics (etiology, size, Visual Analog Scale score, and duration) were recorded. Then, an herbal medicine–oriented treatment protocol combining Zhi Tong Sheng Ji powder (ZTSJ) and SJXP (Sheng Ji Xiang Pi plaster) was applied to these patients. The results suggested that this therapeutic protocol contributed to pain relief and promoted wound healing simultaneously. Specifically, 2 days after applying ZTSJ on wounds, the intensity of pain reduced substantially, and the difference between pre- and post-treatment Visual Analog Scale scores (46 mm vs 23 mm, P < .001) was statistically significant. Epithelialization varied according to ulcer depth. If the wound was deep to the fascia, islands of epithelia did not form within wounds, but rather formed at the edge of wounds, generating island of epithelial cells (IECs) or newly formed epithelial tissue. If the wound was superficial and the dermis remained, scattered IECs appeared within ulcers and merged eventually. Furthermore, as wound pain decreased, IECs appeared, expanded, and merged, or epithelial proliferation and migration occurred in wound margin, eventually healing wounds. No infection spread, topical rashes, itching, or other allergies occurred in these 12 cases, and the time for recovery ranged from 16 to 163 days. ZTSJ is effective for the treatment of painful leg ulcers, but the specific mechanism is not clear.

scholarly journals Evaluation of the perfusion index according to the visual analog scale in postoperative patients

2018 ◽  
Vol 39 (10) ◽  
pp. 1006-1010 ◽  
Author(s):  
Hakan Tapar ◽  
Mustafa Suren ◽  
Serkan Karaman ◽  
Serkan Dogru ◽  
Tugba Karaman ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Perfusion Index ◽  
Analog Scale

scholarly journals Evaluation of omalizumab at certain time intervals in patients with chronic spontaneous idiopathic urticaria

2019 ◽  
Vol 5 (12) ◽  
pp. 351
Author(s):  
Ömer Kutlu ◽  
Engin Karaarslan ◽  
Nermin Karaosmanoğlu ◽  
Hatice Meral Ekşioğlu
Keyword(s):  
Quality Of Life ◽  
Visual Analog Scale ◽  
Statistical Significance ◽  
Activity Score ◽  
Life Questionnaire ◽  
Post Injection ◽  
Analog Scale ◽  
Time Intervals ◽  
Urticaria Activity Score

<p class="abstract"><strong>Background:</strong> In this study, we aimed to evaluate the response of patient treated with omalizumab at certain time intervals through 6 months with pruritus visual analog scale, urticaria activity score and quality of life indexes.</p><p class="abstract"><strong>Methods:</strong> The study was performed on ten patients diagnosed with chronic idiopathic spontaneous urticaria. The disease was assessed by the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and Dermatology Life Quality Index (DLQI) for every 2 weeks while was assessed by Urticaria Activity Score (UAS-7) and Pruritus Visual Analog Scale (PVAS) for once a week during the 6-month treatment period. Statistical significance was evaluated using the Mann-Whitney <em>U</em> test in SPSS 20.  </p><p class="abstract"><strong>Results:</strong> Pre-treatment values of the DLQI, CU-Q2oL, UAS-7, and PVAS was statistically higher than post-treatment values of these indexes (p&lt;0.05). The mean DLQI/ CU-Q2oL value of the patients before treatment was 17±6.09/ 52.87±22.07 while it was 19.4±16.36 at the end of 2nd-week post-injection per month, and was 21.85±16.56 at the end of 4nd-week post-injection per month during 6-months following. Statistically, PVAS score at the fourth week was higher than 2nd and 4th week (p&lt;0.042, p&lt;0.007).</p><p><strong>Conclusions:</strong> In this study, it was detected that omalizumab had a significant effect on DLQI, CU-Q2oL, UAS-7, PVAS scores in CISU. It can be concluded that significant increase of PVAS score at 4th week compared to scores at 2nd and 3rd week may necessitate the use of omalizumab combined with antihistamines at 4th week of the treatment.</p>

Dreierkombination (Thomapyrin®) ist wirksamer bei Kopfschmerzen als Monosubstanzen und Zweierkombination

2005 ◽  
Vol 24 (07) ◽  
pp. 626-639 ◽  
Author(s):  
V. Pfaffenrath ◽  
L. Pageler ◽  
H. Peil ◽  
B. Aicher ◽  
H. C. Diener
Keyword(s):  
Pain Intensity ◽  
Visual Analog Scale ◽  
A Priori ◽  
Intensity Difference ◽  
Visuelle Analogskala ◽  
Analog Scale ◽  
Pain Intensity Difference

ZusammenfassungDie Wirksamkeit, Sicherheit und Verträglichkeit einer Einzelgabe von zwei Tabletten der fixen Dreierkombination mit 250 mg Azetylsalizylsäure (ASS) plus 200 mg Paracetamol plus 50 mg Koffein (Thomapyrin®) gegenüber zwei Tabletten mit 500 mg ASS, oder zwei Tabletten mit 500 mg Paracetamol, oder zwei Tabletten mit 50 mg Koffein beziehungsweise Plazebo wurde in einer klinischen Studie an 1 743 Patienten geprüft, die ihre episodischen Kopfschmerzen vom Spannungstyp oder ihre Migräne mit und ohne Aura üblicherweise erfolgreich mit verschreibungsfreien Analgetika behandeln. Die Dreierkombination war im a priori definierten primären Endpunkt “Zeit bis zu 50% Schmerzreduktion” sowohl der Zweierkombination aus ASS plus Paracetamol (p = 0,0181), als auch den Monoanalgetika ASS (p = 0,0398) und Paracetamol (p = 0,0016), sowie auch der Monotherapie mit Koffein (p < 0,0001) und Plazebo (p < 0,0001) überlegen. Alle Behandlungen außer der Koffein-Monotherapie waren der Plazebobehandlung überlegen (p < 0,0001). Die überlegene Wirksamkeit der Dreierkombination gilt auch für alle sekundären Endpunkte wie beispielsweise der “Verringerung der Kopfschmerzen auf 10 mm VAS (visual analog scale = visuelle Analogskala zur Schmerzmessung), dem gewichteten % SPID (sum of pain intensity difference = aufsummierte Schmerzintensitätsdifferenz gegenüber dem Ausgangsschmerz in Prozent), dem Ausmaß der Beeinträchtigung der alltäglichen Aktivitäten und der globalen Beurteilung der Wirksamkeit durch die Patienten. Alle Behandlungen waren gut verträglich, die Inzidenz von unerwünschten Begleiterscheinungen war gering.

Perceived Tension, Movement, and Pleasantness in Harmonic Musical Intervals and Noises

2020 ◽  
Vol 37 (4) ◽  
pp. 298-322 ◽  
Author(s):  
Marco Costa ◽  
Mattia Nese
Keyword(s):  
Visual Analog Scale ◽  
Energy Content ◽  
High Pitch ◽  
Analog Scale ◽  
Psychophysical Procedure ◽  
Preliminary Study

Perceived valence, tension, and movement of harmonic musical intervals (from the unison to the octave presented in a low- and high-register) and standard noises (brown, pink, white, blue, purple) were assessed in two studies that differed in the crossmodal procedure by which tension and movement were rated: proprioceptive device or visual analog scale. Valence was evaluated in both studies with the visual analog scale. In a preliminary study, the proprioceptive device was calibrated with a psychophysical procedure. Roughness of the stimuli was included as covariate. Tension was perceived higher in dissonant intervals and in intervals presented in the high register. The higher the high-pitch energy content in the standard noise, the higher the perceived tension. The visual analog scale resulted in higher tension ratings than the proprioceptive device. Perception of movement was higher in dissonant intervals, in intervals in the high register, and in standard noises than in musical intervals. High-pitch spectrum noises were associated with more sense of movement than low-pitch spectrum noises. Consonant intervals and low-register intervals were evaluated as more pleasant than dissonant and high-register intervals. High-pitch spectrum purple and blue noises were evaluated as more unpleasant than low-pitch spectrum noises.

scholarly journals Management of cubital tunnel syndrome by anterior trans-muscular transposition of the ulnar nerve

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Ahmed Shawky Ammar ◽  
Mohamed Ahmed El Tabl ◽  
Dalia Salah Saif
Keyword(s):  
Clinical Outcome ◽  
Ulnar Nerve ◽  
Visual Analog Scale ◽  
Electrophysiological Study ◽  
Cubital Tunnel Syndrome ◽  
Nerve Entrapment ◽  
Cubital Tunnel ◽  
Analog Scale ◽  
Tunnel Syndrome ◽  
Dash Questionnaire

Abstract Background Various surgical options are used for the treatment of ulnar nerve entrapment at the elbow. In this study, anterior trans-muscular transposition of the ulnar nerve was used for the treatment of cubital tunnel syndrome. Objectives To evaluate the surgical results of anterior trans-muscular transposition technique for the treatment of cubital tunnel syndrome with particular emphasis on clinical outcome. Methods Forty patients with cubital tunnel syndrome were operated using anterior trans-muscular transposition technique. Patients were classified into post-operative clinical outcome grades according to the Wilson & Krout criteria, and they were followed up by visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and post-operative clinical evaluation. Results Forty patients with cubital tunnel syndrome who underwent anterior trans-muscular transposition of the ulnar nerve show a significant clinical improvement at 24 months post-surgery regarding visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and the Wilson & Krout grading as 87.5% of the patients recorded excellent and good outcome. Conclusion Anterior transmuscular transposition of the ulnar nerve is a safe and effective treatment for ulnar nerve entrapment at the elbow.

Treating traumatic thoracolumbar spine fractures using minimally invasive percutaneous stabilization plus balloon kyphoplasty: a 102-patient series

2021 ◽  
pp. neurintsurg-2020-017238
Author(s):  
Henri Salle ◽  
Alexandre Meynard ◽  
Emilie Auditeau ◽  
Clément Gantois ◽  
Aymeric Rouchaud ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Open Surgery ◽  
Body Height ◽  
Thoracolumbar Spine ◽  
Visual Analog Scale Score ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Expected Improvement ◽  
Thoracolumbar Fractures ◽  
Analog Scale

BackgroundThere is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).ObjectiveTo assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.MethodsWe retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.ResultsA total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.ConclusionsThis is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.

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